Healthcare Provider Details

I. General information

NPI: 1871715649
Provider Name (Legal Business Name): PAIN AND HEALTH MANAGEMENT CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 GESSNER RD. SUITE 970
HOUSTON TX
77024
US

IV. Provider business mailing address

915 GESSNER RD SUITE 970
HOUSTON TX
77024-2527
US

V. Phone/Fax

Practice location:
  • Phone: 713-932-0770
  • Fax: 713-932-8595
Mailing address:
  • Phone: 713-932-0770
  • Fax: 713-932-8595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberH6111
License Number StateTX

VIII. Authorized Official

Name: DR. JEFFREY HAL CHARNOV
Title or Position: PARTNER
Credential:
Phone: 713-932-0770